Errors and Compliance in Coding
Axia College UOP
Friday, June 17, 2011
According to NPR (National Public Radio) a third of all medical bills contain errors (2006). Of all possible errors within billing and coding, data entry mistakes, incorrect dating of services or procedures, and duplicate billing are the most common. Data entry mistakes or typos appear to be the most common of all billing mistakes. Data entry mistakes can happen during any aspect of preparing billing statements, from something as small as an error in the spelling of a patients name to the incorrect documentation of the dosage of a medication a patient may have received. Incorrect dates can also affect billing. If a payer ends up being billed for a procedure that was performed on one date but the bill date falls completely outside the time frame the payer expects the payer may deny reimbursement or payment. Duplicate billing can occur when two bills are produced for one service or when one service is coded two different ways. Ways to avoid or lessen the likely-hood of mistakes are: 1. Patients can help to reduce doubling by reading and reporting any errors the notice on billing statements they receive. 2. Staff should be well trained with an expertise in coding. 3. There is also Scrubbing software that may be used to identify mistakes. The Medicare National Correct Coding Initiative has forced doctors to “stay honest” when it comes to the billing process. This is done by Medicare’s computer system which has the ability to use many CPT code combinations to check claims.
Axia College. (2011). Week Seven Chapter Read: Claim Preparation. Retrieved June 13, 2011, from Axia College, Week Seven, HCR/220 – Claims Preparation1 Course Web site. Singletary, M. (2006. Americans Paying for Medical Billing Errors. National Public Radio.Retrieved June 15, 2011 from http://www.npr.org/templates/story/story.php?storyId=5348863.
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